Individual provider Active NPI

Jennifer S Kitchin, MD

  • Dermatology Physician
  • Harrison, NY
National Provider Identifier
1659397032
Registry record updated Jul 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
2119391 Issued in NY
Practice address
440 Mamaroneck Ave
412
Harrison, NY 10528-2418
Phone
(914) 777-1799
Fax
(914) 777-1899
NPI assigned
Jul 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 2119391 NY Primary

Addresses

Primary practice location

440 Mamaroneck Ave
412
Harrison, NY 10528-2418

Mailing address

440 Mamaroneck Ave
412
Harrison, NY 10528-2418
Phone (914) 777-1799

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070103000177 NY Practitioner - Dermatology 5395745004 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
New York University School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatology Associates of New York, PLLCGroup PAC ID 4385968601, 2 clinicians

Practice addresses (Care Compare)

440 Mamaroneck Ave
Suite 404
Harrison, NY 10528-2433
Phone (914) 777-1799

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions131
Skin biopsy97

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2119391NYMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology Associates of New York, PLLC Dermatology CurrentSince Jan 1, 2015 Accepting new patients

Locations

440 Mamaroneck Ave
Ste 404
Harrison, NY 10528
Phone (914) 777-1799

440 Mamaroneck Ave
Ste 412
Harrison, NY 10528
Phone (914) 761-8667

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310947200000",
    "number": "1659397032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 MAMARONECK AVE",
            "address_2": "412",
            "city": "HARRISON",
            "state": "NY",
            "postal_code": "105282418",
            "telephone_number": "914-777-1799",
            "fax_number": "914-777-1899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 MAMARONECK AVE",
            "address_2": "412",
            "city": "HARRISON",
            "state": "NY",
            "postal_code": "105282418",
            "telephone_number": "914-777-1799",
            "fax_number": "914-777-1899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KITCHIN",
        "first_name": "JENNIFER",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-15",
        "last_updated": "2011-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "2119391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrison, NY

Sources for this page

Verify at the official NPI Registry.